High glycemic variability is associated with worse Continuous Glucose Monitoring metrics in children and adolescents with type 1 diabetes

2021 ◽  
Author(s):  
Claudia Piona ◽  
Marco Marigliano ◽  
Enza Mozzillo ◽  
Francesca Di Candia ◽  
Angela Zanfardino ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Glucose Monitoring ◽  
Binary Logistic Regression ◽  
Glycemic Variability ◽  
Diabetes Type ◽  
Lower Proportion ◽  
Binary Logistic Regression Analysis ◽  
Determining Factors ◽  
The Relationship

Objective: The primary aim of this study was to quantify the prevalence of children and adolescents with T1D who achieve the recommended target for CV identifying the determining factors to reach this target. The secondary aim was to examine the relationship between CV, the other metrics derived from CGM data and clinical parameters. Method: CGM data were collected from 805 children/adolescents with T1D. Several CGM metrics and patients' characteristics were evaluated. Participants were stratified by CV≤36% and CV>36%. Binary logistic regression analysis was run to identify the determining factors of high CV. Results CV was positively correlated with %TBR<70mg/dL, %TBR<54 mg/dL, %TAR>250 mg/dL, LBGI, HBGI and negatively with %TIR. CV≤36% was found in 31.4% of the subjects. The CV>36% group spent less time in %TIR, more time in hypoglycemia and hyperglycemia with lower proportion of subjects using rtCGM and CSII. Percentage of TBR<70mg/dL and TAR>250mg/dL were significant predictors of CV>36%, whereas age, gender, BMI, duration of diabetes, type of CGM device, type of insulin therapy administration and %TIR were not significant predictors (p<0.001,R2Nagelkerke=0.48). Conclusions: CV identifies children and adolescents with worse glycemic control at higher risk of both hypoglycemia and hyperglycemia.

Continuous Glucose Monitoring for Glycemic Control in Children and Adolescents Diagnosed with Diabetes Type 1: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Elena Dorando ◽  
Thomas Haak ◽  
Dawid Pieper
Keyword(s):  
Systematic Review ◽  
Glycemic Control ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Glucose Monitoring ◽  
Diabetes Type ◽  
Diabetes Type 1 ◽  
Meta Analyses

Abstract Aim The aim of this meta-analysis was to evaluate the impact of continuous glucose monitoring (CGM) systems on short- and long-term glycemic control in children and adolescents diagnosed with diabetes type 1. Methods The review was registered in PROSPERO (CRD42019135152). We partly updated a formerly published systematic review and searched several databases (Ovid MEDLINE, Embase, CENTRAL, and Clinicaltrials.gov) in May 2019. Summary measures were estimated as relative risks (RR) and standardized mean differences (SMD). The primary endpoint of our analysis was frequency of hypoglycemic events. Quality of evidence was evaluated using the GRADE approach. Results Eleven studies with a total number of 818 patients were included in our review. Meta-analyses indicated a potential benefit of CGM systems regarding the relative risk of a severe hypoglycemic event (RR 0.78; 95% CI 0.29 to 2.04) and mean level of HbA1c at end of study (SMD -0.23; 95% CI -0.46 to 0.00). Certainty of evidence for effect estimates of these meta-analyses was low due to risk of selection bias and imprecision of the included studies. Qualitative analyses of the secondary outcomes of user satisfaction and long-term development of blood glucose supported these findings. Conclusion CGM systems may improve glycemic control in children and adolescents diagnosed with diabetes type 1, but the imprecision of effects is still a problem. Only a few studies examined and reported data for pediatric populations in sufficient detail. Further research is needed to clarify advantages and disadvantages of CGM systems in children and adolescents.

Glycemic Variability and Insulin Needs in Patients with Type 1 Diabetes Mellitus Supplemented with Vitamin D: A Pilot Study Using Continuous Glucose Monitoring System

2018 ◽  
Vol 14 (4) ◽  
pp. 395-403 ◽  
Author(s):  
Karem Mileo Felício ◽  
Ana Carolina Contente Braga de Souza ◽  
Joao Felicio Abrahao Neto ◽  
Franciane Trindade Cunha de Melo ◽  
Carolina Tavares Carvalho ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Type 1 Diabetes ◽  
Pilot Study ◽  
Type 1 Diabetes Mellitus ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability

Abstract 3734: Presurgical fMRI and Morbidity Outcomes in Patients with Vascular Lesions

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Andrew C Radtke ◽  
Joshua Pankratz ◽  
Ryan Holdsworth ◽  
Dovile Baniulis ◽  
Nicole Kornder ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preoperative Planning ◽  
Binary Logistic Regression ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Motor Deficits ◽  
Binary Logistic Regression Analysis ◽  
Language Mapping ◽  
Motor Mapping ◽  
The Relationship

Background fMRI is being increasingly used as an adjunct imaging technique for preoperative planning for patients with various brain lesions. The proximity of the lesion to eloquent cortex is a major factor in guiding surgical planning. Our group has previously reported significant association between the distance between brain tumor periphery and area of fMRI activation (Lesion-Activation Distance; LAD) and morbidity and mortality outcomes. This study investigated the relationship between vascular lesion LAD and morbidity. Methods This study was a retrospective analysis of data from patients with vascular lesions [arteriovenous malformations (AVMs) (n=49), and cavernomas (n=57)], who had received fMRI as part of their preoperative planning. The preoperative fMRI included motor mapping (n=87) and/or language mapping (n=102). The fMRI paradigms were chosen based on observed preoperative weakness (aphasia, paresis) and anticipated functional areas of the brain that may be affected by treatment. Results Multiple logistic regression analyses showed that a model that combines Age and Language LAD was a significant predictor of postoperative deficits (p= 0.04). Broca’s LAD(1-2 cm) X Age was a significant predictor of postoperative deficits (change in odds ratio (OR) =0.82, CI:0.68-0.98). The relationship between Brocas’s LAD and postoperative aphasia and Broca’s LAD and pre and postoperative aphasia trended towards significance (p = .08 and p =.07 respectively). Wernicke’s LAD, independently or combined with Age, was not a significant predictor of postoperative deficits. Binary logistic regression analysis for SMC LAD and postop deficits did not reach significance (p =.10). There were no significant differences in postoperative language or motor deficits as a function of gender or handedness. Conclusions These results suggest that both age and the proximity of a vascular lesion to language LAD are factors that can help predict postoperative outcomes, especially for Broca’s LAD. The lack of similar results when investigating the relationship between Wernicke’s LAD and postoperative deficits suggests potential brain reorganization and/or robustness of this brain region. These results have implications for the potential use of fMRI as a presurgical tool for language mapping in patients with vascular lesions.

Relationship between oxidative stress and blood glucose fluctuations evaluated with daily glucose monitoring in children with type 1 diabetes mellitus

2016 ◽  
Vol 29 (4) ◽  
Author(s):  
Ayça Altıncık ◽  
Birsen Tuğlu ◽  
Korcan Demir ◽  
Gönül Çatlı ◽  
Ayhan Abacı ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Glucose Monitoring ◽  
Insulin Requirement ◽  
Diabetes Duration ◽  
Oxidative Stress Marker ◽  
Entire Group ◽  
Anthropometric Data ◽  
Glucose Fluctuations ◽  
The Relationship

AbstractThe aim of this study is to determine the relationship between oxidative stress marker (8-iso-prostaglandine FThirty-one children and adolescents with T1DM (median age 12.2 years) and healthy subjects (median age 11.7 years) were enrolled into the study. Anthropometric data were recorded for the entire group before the study. In addition, diabetes duration, insulin requirement, lipid values, microalbuminuria, HbAMedian diabetes duration was 5 years, hemoglobin AThis study showed that, 8-iso-prostoglandine F

scholarly journals Association between the non-HDL-cholesterol to HDL-cholesterol ratio and non-alcoholic fatty liver disease in Chinese children and adolescents: a large single-center cross-sectional study

2020 ◽  
Author(s):  
Shouxing Yang ◽  
Jinwei Zhong ◽  
Mengsi Ye ◽  
Lei Miao ◽  
Guangrong Lu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Children And Adolescents ◽  
Binary Logistic Regression ◽  
Hdl Cholesterol ◽  
Chinese Children ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Chinese Children And Adolescents

Abstract Background: The non-HDL-cholesterol to HDL-cholesterol (NHDLC/HDLC) ratio is closely related to a variety of dyslipidemia-related diseases. This study aimed to inspect the relationship between the NHDLC/HDLC ratio and non-alcoholic fatty liver (NAFLD) in children and adolescents.Methods: In this cross-sectional survey, a total of 7,759 eligible Chinese children and adolescents (5,692 boys and 2,067 girls) received routine medical examinations. The anthropometric and laboratory data of the subjects were collected. NAFLD was diagnosed by liver ultrasonography. Binary logistic regression analysis was performed on the NHDLC/HDLC ratio, NHDLC, HDLC and NAFLD. Receiver operating characteristic (ROC) curve analysis was exploited to compare the diagnostic significance of the above parameters for NAFLD.Results: The total prevalence of NAFLD was 4.36%, and the prevalence in boys was higher than that in girls (5.61% vs. 1.9%, P < 0.001). The prevalence of NAFLD was positively correlated with the NHDLC/HDLC ratio (P < 0.001). The binary logistic regression analysis demonstrated that the OR was 8.61 (95% CI, 5.90-12.57, P < 0.001) in tertile 3 (highest NHDLC/HDLC ratio) compared with tertile 1 (lowest NHDLC/HDLC ratio). After adjustment for age, sex, body mass index (BMI), alanine aminotransferase (ALT), uric acid (UA), total bilirubin (TB), fasting plasma glucose (FPG) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), the OR for tertile 3 (OR=1.83, 95% CI, 1.04-3.22, P = 0.035) was still significantly higher than that of tertile 1. The area under the curve (AUC) of the NHDLC/HDLC ratio of boys was 0.787, which was significantly greater than that of NHDLC and HDLC (0.719 and 0.726, P < 0.001). For girls, the AUC of the NHDLC/HDLC ratio was 0.763, which was also significantly greater than that of NHDLC (0.661, P < 0.001). Furthermore, the cutoff point of the NHDLC/HDLC ratio was 2.475 in boys and 2.695 in girls. In addition, the AUC of the NHDLC/HDLC ratio was 0.761 in subjects with normal ALT levels (ALT ≤ 40 U/L), which was significantly higher than that of NHDLC (0.680, P < 0.001) and HDLC (0.724, P = 0.007). For subjects with elevated ALT levels (ALT > 40 U/L), the AUC of the NHDLC/HDLC ratio (0.746) was also significantly greater than that of NHDLC (0.646, P < 0.001)Conclusions: The NHDLC/HDLC ratio was positively correlated with NAFLD in Chinese children and adolescents. It may serve as an effective indicator to help identify NAFLD in children and adolescents.

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